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Related Experiment Video

Updated: Jun 30, 2025

A Community-based Stress Management Program: Using Wearable Devices to Assess Whole Body Physiological Responses in Non-laboratory Settings
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Patient Engagement With and Perspectives on a Mobile Health Home Spirometry Intervention: Mixed Methods Study.

Andrew W Liu1, William Brown Iii1,2,3,4, Ndubuisi E Madu1

  • 1Center for Digital Health Innovation, University of California, San Francisco, CA, United States.

JMIR Mhealth and Uhealth
|March 20, 2024
PubMed
Summary

Remote patient monitoring (RPM) in mobile health (mHealth) shows lower engagement in lung transplant patients transplanted over a year ago or who are non-English speakers. Improving personalization and transparency can reduce attrition.

Keywords:
attritioncomplicationcomplicationsdevicedevicesdropouteHealthengagementexperienceexperiencesinterviewinterviewslunglung transplantlungsmHealthmethodsmobile healthmonitormonitoringnumerical dataorganorganspatient-centered carepulmonaryremote patient monitoringrespiratoryspirometrystatisticstelemedicinetransplanttransplantationtransplants

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Area of Science:

  • Digital Health
  • Transplant Medicine
  • Patient Engagement

Background:

  • Patient attrition in mobile health (mHealth) remote patient monitoring (RPM) programs diminishes benefits and highlights systemic disparities in adoption and use.
  • Understanding real-world patient experiences, particularly among those who discontinue use, is crucial for enhancing mHealth value and reducing attrition.

Purpose of the Study:

  • To investigate patient engagement and experiences within an mHealth RPM intervention specifically designed for lung transplant recipients.
  • To identify factors influencing patient engagement and barriers to sustained use in this population.

Main Methods:

  • A cohort of 601 lung transplant recipients was enrolled in an mHealth RPM program for lung function monitoring.
  • Multivariable logistic and linear regression analyses were used to identify predictors of patient engagement.
  • Semistructured interviews were conducted with patients who disengaged after initial use to explore their experiences and identify common themes.

Main Results:

  • Patients transplanted over a year prior had significantly lower odds of engagement, data submission, and checklist completion.
  • Non-English speakers exhibited substantially lower odds of engagement compared to English speakers.
  • Interview themes included device challenges, communication issues, a need for personalized feedback, and a lack of clarity regarding data usage and chat functions.

Conclusions:

  • Improving care delivery and equity in RPM for lung transplant patients requires tailored outreach for non-English speakers and those further from transplant.
  • Enhancing program design with personalized provider contact, clear education, and transparent data usage policies can decrease patient attrition rates.